Spontaneous pneumomediastinum: A comprehensive review of diagnosis and management.

Rajeev A, Rachapudi S, Khan S, Singh V, Talwar A
Intractable & rare diseases research · 2024 · doi:10.5582/irdr.2024.01020 · PMID:39220281 · PMC11350202
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⚙ AI-generated summary by claude@2026-07, 2026-07-17 ⓘ

This review of 24 case series from 1980-2023 found spontaneous pneumomediastinum primarily affects young males presenting with chest pain and dyspnea, with risk factors including asthma, smoking, and physical activity.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-17 · read from full text ⓘ

This paper is a systematic review of the literature on spontaneous pneumomediastinum (SPM), defined as air in the mediastinum without trauma, iatrogenic injury, or an identifiable cause, focusing on how patients present and how SPM is evaluated and managed. The authors searched MEDLINE/PubMed and Google Scholar for articles from 1980–2023 and included 24 English-language case series, summarizing symptoms, exam findings, and predisposing factors; most patients were male (average age 26.3 years), with chest pain and dyspnea as the most common symptoms and subcutaneous emphysema in 35.4% of cases (Hamman’s sign in 5.9%). A key limitation is that the evidence base consisted of case series rather than controlled studies. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Pneumomediastinum is a rare condition defined by the presence of air in the mediastinum. In the absence of traumatic injury, iatrogenic injury, or clear etiology, it is called spontaneous pneumomediastinum (SPM). Spontaneous pneumomediastinum most commonly occurs in younger individuals and has a self-limiting course with a good outcome. The purpose of the present manuscript is to systematically review the existing literature on SPM evaluation and management for updated clinical understanding of this condition. A literature search was conducted of publications about SPM on MEDLINE/PubMed and Google Scholar by identifying all the articles with key search terms "pneumomediastinum" and "spontaneous pneumomediastinum". Inclusion criteria were case series published in English between 1980 and 2023. In total, 24 case series were selected and reviewed to determine presenting symptoms, clinical signs and predisposing factors associated with spontaneous pneumomediastinum. Most patients were male; the average age at diagnosis was 26.3 years. The most common presenting symptoms were chest pain and dyspnea. The most common exam finding was subcutaneous emphysema, in 35.4% of patients. Only 5.9% had the classic Hamman's sign. Risk factors include history of asthma, history of smoking, and recent physical activity. This manuscript presents an extensive review of relevant literature highlighting the diagnosis and essential management of spontaneous pneumomediastinum.
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Keywords

spontaneous pneumomediastinum, mediastinal emphysema, chest pain, subcutaneous emphysema, systematic review 2024 Volume 13 Issue 3 Pages 138-147 Details

Abstract

Pneumomediastinum is a rare condition defined by the presence of air in the mediastinum. In the absence of traumatic injury, iatrogenic injury, or clear etiology, it is called spontaneous pneumomediastinum (SPM). Spontaneous pneumomediastinum most commonly occurs in younger individuals and has a self-limiting course with a good outcome. The purpose of the present manuscript is to systematically review the existing literature on SPM evaluation and management for updated clinical understanding of this condition. A literature search was conducted of publications about SPM on MEDLINE/PubMed and Google Scholar by identifying all the articles with key search terms "pneumomediastinum" and "spontaneous pneumomediastinum". Inclusion criteria were case series published in English between 1980 and 2023. In total, 24 case series were selected and reviewed to determine presenting symptoms, clinical signs and predisposing factors associated with spontaneous pneumomediastinum. Most patients were male; the average age at diagnosis was 26.3 years. The most common presenting symptoms were chest pain and dyspnea. The most common exam finding was subcutaneous emphysema, in 35.4% of patients. Only 5.9% had the classic Hamman's sign. Risk factors include history of asthma, history of smoking, and recent physical activity. This manuscript presents an extensive review of relevant literature highlighting the diagnosis and essential management of spontaneous pneumomediastinum. © 2024 International Research and Cooperation Association for Bio & Socio-Sciences Advancement Favorites & Alerts Recently viewed articles

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